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Program planning framework intended to facilitate the development of theory- and evidence-based health promotion programs

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1. Program planning framework intended to facilitate the development of theory- and evidence-based health promotion programs. Following a thorough review of the literature and an appropriate needs assessment, the process of intervention mapping includes five steps: "1) creating matrices of proximal program objectives from performance objectives and determinants of behavior and environmental conditions; 2) selecting theory-based intervention methods and practical strategies; 3) designing and organizing programs; 4) specifying adoption and implementation plans; and 5) generating an evaluation plan." In step one, a list of performance objectives are generated that define the desired behavioral and environmental outcomes of the program; personal (internal) and external determinants of the behavioral and environmental outcomes are specified; if determinants vary by sub-population, the target population is differentiated; and, finally, performance objectives and determinants are linked in a matrix format, often by level (i.e. individual vs. organizational) and by sub-population, if applicable. Each cell in the resulting matrices will contain either a learning objective (linking a performance objective with a personal determinant) or a change objective (linking a performance objective with an external determinant) that defines what individuals need to learn or what changes need to take place in the environment as a result of the program. In step 2, a list of theoretical intervention methods (i.e. community planning) and a list of possible strategies for delivering those methods (i.e. community forums or meetings) are developed, based on the identified proximal objectives. In step 3, the selected strategies are operationalized into deliverable program components and delivery mechanisms (i.e. channel selection), and program materials are developed and pre-tested. During step 4, a "linkage system" between program users and developers is created so that the program can be modified to meet the needs of the users; adoption and implementation performance objectives are developed; determinants of adoption and implementation are specified; and an implementation plan is developed. Finally, step 5 involves developing an evaluation model, including a plan for process evaluation.
2. Program-specific message delivered to an individual or group that is designed to increase awareness of a health problem, motivate behavior change, address perceived barriers to engaging in a health behavior, or something else related to the goals and objectives of the program. Theory-based and tailored intervention messages are typically the most effective.
3. Member of the target community that is trained to administer health promotion messages and program activities. Lay health advisors are often used to overcome language barriers, to enhance the cultural relevance of health promotion programs, to facilitate access to and understanding of a community among program planners, to help connect members of the target population with services, etc.
4. Reflect the different points of prevention and intervention in health education and health promotion
5. Generalized belief that circumstances and rewards are under one's own (internal locus of control) or others' control (external locus of control).
6. Factor that partially or completely explains the relationship between a predictor and a behavior or outcome. A mediating factor is independently related to the outcome of interest and to the predictor of interest, thereby acting as a link between the two. For example, in the Theory of Reasoned Action, a person's behavioral intention acts as a mediating factor between his attitude and subjective norms and his behavior.
7. Brief statement that defines the purpose and focus and sometimes the vision and values of an organization or program. Typically, all program planning, program activities, partnerships, etc. should be made to reflect to the mission statement to ensure that they are in line with the overall purpose and goals of the program or organization.
8. Strategic and systematic combination of qualitative and quantitative research methods. The combination of methods often works to overcome the limitations of quantitative or qualitative methods used in isolation, to improve the validity of findings, and/or to provide a more comprehensive understanding of a problem or phenomenon.
9. Directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence ." 17 Motivational interviewing emphasizes drawing out an individual's internal motivations to change; allowing an individual to express and resolve her own ambivalence towards a behavior; and avoiding direct persuasion, confrontation and argumentation. The individual is viewed as the expert, while the primary role of the interviewer is to facilitate the individual's expression of goals and the discovery of an acceptable resolution to the ambivalence. In theory, an individual's ambivalence is the principle barrier to behavior change.
10. U.S. Department of Health and Human Services has coordinated a process to develop a set of national health objectives to direct public health efforts each decade since 1980, starting with the publication of Promoting Health/Preventing Disease: Objectives for the Nation. The current set of national health objectives is contained in Healthy People 2010: Understanding and Improving Health . Healthy People 2010 contains 467 national health objectives that cover 28 primary focus areas.